Many women experience pain and discomfort in the vulva at some point in their lives. When the pain is persistent for more than three months and has no apparent cause, it’s called vulvodynia.

It’s estimated that 16 percent of women in the United States will have vulvodynia at some point in their lives. Vulvodynia can occur at any age, but recent research has found that women between the ages of 20 and 40 years are most likely to experience it.

What is the vulva?

The vulva is the tissue around the opening to the vagina. It includes the outer folds of skin, called the labia majora, and the inner folds, called the labia minora. Other parts include:

Generalized vulvodynia

Generalized vulvodynia starts spontaneously. It causes general vulvar pain and can last for months or even years at a time.

Localized vulvodynia

Pain that is centered around a certain area in the vulva is referred to as localized vulvodynia. For example, the pain may be in the folds or “lips” of the vagina. This pain often appears and then disappears.

Cyclic vulvitis

This vulvar pain comes and goes with a woman’s menstrual cycle. Pain generally tends to be worse right before monthly menstruation starts.

Vestibulodynia

This is vulvar pain that occurs at the opening, or vestibule, of the vagina.

Most women with vulvar pain report a burning, stinging, or throbbing discomfort in the vaginal area. Sometimes, the pain is constant. Other times, it’s only felt when there is pressure on the area. That pressure may be caused by:

sex

inserting a tampon

sitting

wearing tight, form-fitting pants

The vulvar tissue often looks healthy and normal in people with vulvar pain.

Vulvar pain isn’t well understood. Vulvar pain is not contagious, nor is it spread through sex. It’s also not a sign of cancer.

Researchers have seen a link between vulvar pain and some conditions and factors in some women, such as the following.

Recurrent yeast infections

In one study, mice that were subjected to and treated for yeast infections three times were more likely to encounter vulvar pain than mice without yeast infection. The researchers theorized that the multiple yeast infections increased the production of nerve fibers in the mice. The increased nerve fibers resulted in more vulvar pain.

The study used mice, not humans, so more research is needed to determine the link between yeast infection and vulvar pain in women.

Genetic disorders

Some women are born with genetic differences that cause cells to overreact to inflammation or hormones. That can cause pain when inflammation occurs in the vulvar region. Inflammation causes tissue to swell, fill with more blood, and feel hot and sore.

Physical or sexual trauma

Vulvar nerve endings can become damaged during childbirth, sexual abuse, or sex without enough vaginal lubrication. Activities that put a lot of pressure on the vaginal region, such as bicycling or horseback riding, can also harm nerve endings and tissue.

Chronic pain conditions

Women with vulvodynia may be 2 to 3 times more likely to have chronic pain conditions like fibromyalgia and irritable bowel syndrome. Both of those are inflammatory diseases, so this type of vulvodynia may be related to inflammation as well.

Allergies

Soaps, gels, and feminine deodorant products can cause an allergic reaction in the vulvar region in some women. That can lead to irritation, inflammation, and pain.

Hormone therapy

One study found that women with chronic vulvar pain were more likely to have used hormone therapy than those who didn’t have pain. According to another study, there doesn’t appear to be a link between vulvar pain and the use of birth control, however.

It’s important to talk openly with your doctor about vulvar pain. Vulvar pain can affect your lifestyle and relationships. Your doctor can help identify the cause of your pain so that you can begin treatment.

Your doctor will take your medical and sexual history. They may ask whether:

you’ve been treated for vaginal infections

your pain is worse with sex

you have vaginal dryness

Your physician will perform a pelvic exam to look for signs of inflammation or infection. They may also take a tissue sample to test for a bacterial or yeast infection. They may use a cotton swab to gently probe the vaginal area to help determine if your pain is generalized or located in only one spot.

If an infection is causing your pain, your doctor will treat it. If your pain is caused by an allergic reaction to a product, your doctor will recommend you stop using that product. They may also prescribe an anti-inflammatory cream.

If no cause for your pain can be found, your doctor will help you manage the discomfort. They may recommend some of the following treatments:

pain-relieving creams, such as those containing lidocaine, applied directly to the skin